| NPI | 1053433284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TN 1625) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 0832) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2022-08-16 |